Theory of Acute Pain Management
Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept.
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Non-pharmacological adjuvants are non-medicinal elements which could include music, relaxation, breathing techniques, imagery, distraction, and massage (Sylvia, Carol, LeeAnn & MSN, 2011). Assessments of pain and side effects refer to the examination of a patient at regular intervals of time. Intervention and reassessment is based on changes related to previous pain and side effect assessments. Patient education is training individuals on how to manage or prevent pain with medication and activity. Goal setting is designed to aid in maintaining and reducing pain by allowing the patient, nurse, and doctor to work together in order to form a plan of pain management. All concepts work together to promote a balance between analgesia and side effects.
The major concepts of this theory are defined theoretically since the use of these definitions is from a broader theoretic concept. Therefore, an operational concept could be developed from them. There is consistency in the use of these concepts throughout the theory of acute pain management with examples given using the same language as well as maintaining the integrity of the concepts.
Description of Theory
Multimodal intervention along with attentive care and patient participation is necessary to achieve a balance between analgesia and side effects. Assumptions to the conceptual framework must be identified to understand the specific relevance of the theory to pain
pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain
Research has shown that there are several organizations and active advocates who are working on pain management problems to face this public health issue. The following establishments involve: The American Academy of Pain Medicine, Institute of Medicine, and American Pain Society and many for-profit and nonprofit organizations are also working at different level towards pain management. Most specifically, the IOM has been devoted to studying pain and its consequences on individuals, the healthcare system, as well as on government (IOM, 2011).
“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,
The relationship discovered in the articles written by Denneson, et., al (2011) and Fletcher, et., al (2016) discuss how the Department of Veterans Affair is studying the significance of using complementary alternative medicine to effectively control chronic noncancerous pain versus the continuous use of opioids. Massage therapy was the most preferred and effective method for management of pain. In the article written by Fletcher, et., al (2016), about 60 percent of the outpatient was taking opioids for management of chronic pain.
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety
According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,
The following analysis will observe various methods of CAM pain reduction, highlighting two major CAM therapies of interest: music therapy, animal therapy. In addition, the following analysis will discuss how different demographics react to such therapies, with gender, age, ethnicity, and education level playing a role in relation to a patient’s willingness to be open to CAM. Lastly this analysis will discuss the drawbacks of CAM therapies in the medical community today, emphasising a lack of discussion between provider and patient, and the general lack of clinical education surrounding CAM therapies within the medical community.
Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations
Despite the fact that pain is universally recognized as a part of the healing process, ways to minimize its impact on patients have not been aggressively pursued. The modern perspective of pain merits the use of painkillers for both short term and chronic pain, but studies suggest that the likelihood of drug dependence increases with the intensity of the pain, extent of drug use, and frequency of drug use. (Elander, Duarte, Maratos, & Gilbert, 2013). Patients may prefer not to use painkillers such as opioids due to debilitating side effects and fear of developing dependence, yet there are few alternative methods taught to patients to help manage pain.
The implementation of pain management based on the best available evidence implies the comprehensive assessment of pain with a reliable and valid assessment instrument, the application of pharmacological and non-pharmacological interventions based on the findings of the evaluation, the frequent re-evaluation of pain to know the level of response to treatment. Although evidence-based pain management
basic human right). The goal of using this pain management strategy are to reduce postoperative
Pain management in burn unit hospitals continues to be a major challenge for many hospitalized patients of all ages. Patients who are required to be hospitalized are usually ones who have moderate to severe burns that result in traumatic tissue damages. The topic of this research paper will be about pain management in patients with burns. The purpose of this paper is stated in following as a patient intervention comparison and outcome (PICO) format, in patients with severe burns who requires routine dressing changes, how does the combination of pharmacological and non-pharmacological pain management compare to using pharmacological pain management alone affect the patient’s overall pain experience?
The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.
Engwall (2009) defined pain as a "symptom and a warning that something is wrong in an organism” (p 370). Rathmell et al., (2006) maintained that fear of uncontrolled pain can be a traumatic situation for a patient undergoing surgery. Moreover, Pellino, et al (2005) sustained that “pain is a multidimensional experience, consisting of not only physical stimuli but also psychological interpretations of pain” (p. 182). Alleviating peri-operative pain is traditionally achieved with the use of pharmacological interventions. analgesia can incur undesirable side-effects like drowsiness, nausea and vomiting. Controlling the pain by complimenting analgesics with the use of non-pharmacological interventions, might ameliorate patients’ response to pain with fewer resultant side-effects. Thus, the need to evaluate the effect of non-pharmacological measures such as music, relaxation, hypnosis and others is highly solicited in the evolving heath system (Pyati & Gan, 2007).